Stieger Roland, Kniestedt Christoph, Sutter Florian, Bachmann Lucas M, Stuermer Joerg
Department of Ophthalmology, Cantonal Hospital Winterthur, Winterthur, Switzerland.
Clin Exp Ophthalmol. 2007 Jul;35(5):409-13. doi: 10.1111/j.1442-9071.2007.01510.x.
To assess and describe the prevalence and clinical features associated with plateau iris syndrome (PIS) in young individuals with recurrent angle closure despite initial therapy.
Chart review of 137 relatively young individuals (aged < 60 years) with symptoms of angle closure between 1995 and 2005. A follow-up period of 36 months after initial presentation was retrospectively analysed. Seventy-six patients with recurrent angle closure symptoms were clinically reviewed using gonioscopy and ultrasound biomicroscopy.
Based on chart analysis, 30 of 137 individuals were diagnosed with PIS (22%). After clinical review, 34 additional patients suffered from PIS as the underlying cause for persistent angle closure symptoms. The prevalence of PIS in our patient population with recurrent angle closure symptoms in spite of initial iridotomy or iridectomy was 54%.
Among angle closure in young individuals, PIS is not uncommon. The causative mechanism of PIS in young individuals is peripheral iris block, rather than pupillary block which is more often prevalent in older patients. For proper diagnosis and therapy, ultrasound biomicroscopy and gonioscopy should be performed on every young individual with angle closure symptoms.
评估并描述尽管接受了初始治疗但仍反复发生房角关闭的年轻个体中高原虹膜综合征(PIS)的患病率及临床特征。
回顾性分析1995年至2005年间137例相对年轻(年龄<60岁)有房角关闭症状患者的病历。对初次就诊后36个月的随访期进行回顾性分析。对76例有反复房角关闭症状的患者进行房角镜检查和超声生物显微镜检查的临床评估。
根据病历分析,137例个体中有30例被诊断为PIS(22%)。经过临床评估,另有34例患者患有PIS,这是持续性房角关闭症状的潜在原因。在我们尽管接受了初始虹膜切开术或虹膜切除术仍有反复房角关闭症状的患者群体中,PIS的患病率为54%。
在年轻个体的房角关闭病例中,PIS并不少见。年轻个体中PIS的致病机制是周边虹膜阻滞,而非在老年患者中更常见的瞳孔阻滞。为了进行正确的诊断和治疗,应对每例有房角关闭症状的年轻个体进行超声生物显微镜检查和房角镜检查。